Insurance Verification & Billing Specialist

Insurance Verification & Billing Specialist Eastlake Cardiovascular

PC - 1.6

Saint Clair Shores, MI Job Details Full-time 23 hours ago Benefits Paid holidays Disability insurance Health insurance Dental insurance Paid time off Vision insurance Qualifications Appeals Customer communication Overseeing health insurance pre-certification Medicare Patient management software Medicaid health insurance Electronic health record (EHR) management for billing and coding Medical billing and coding communication with insurance companies Medical insurance appeals management Medical claims submission Medicaid Insurance claims appeal handling

Full Job Description Job Title:

Insurance Verification & Billing Specialist Eastlake Cardiovascular, P.C.

Location:

St. Clair Shores, MI (On-site)

Job Type:

Full Time Full-time | Weekdays | No evenings or weekends

About Us:

We are a high-volume, patient-focused cardiology practice dedicated to providing exceptional cardiovascular care. Our team is committed to excellence in both clinical outcomes and administrative support to ensure patients receive timely and accurate services. We are currently seeking a skilled Insurance Verification & Billing Specialist with strong authorization and denial resolution experience to join our growing team. Eastlake Cardiovascular, PC offers: Competitive Benefits, including medical, dental, vision through BCBS Short-Term Disability (STD), Paid holidays PTO A weekly 8-hour shift schedule no nights or weekends

Position Summary:

This role focuses on insurance verification , referral and authorization processing , patient benefit review, and general billing questions. Unlike a coding-heavy role, this position is ideal for someone who excels in pre-visit authorization approvals , working with insurance companies on denials or benefits clarification , and supporting billing accuracy .

Key Responsibilities:

Perform insurance eligibility and benefit verification in advance of scheduled patient visits using payer portals and clearinghouse systems Manage and track referrals and authorizations for office visits, diagnostic testing (e.g., stress tests, echocardiograms, nuclear studies), and procedures Review insurance benefits to determine patient financial responsibility, including copays, deductibles, and coinsurance amounts Communicate coverage details and expected out-of-pocket costs clearly and proactively to patients prior to services being rendered Analyze and interpret Explanation of Benefits (EOBs) to support accurate payment posting and reconciliation Research and resolve denied or unpaid claims, including initiating and tracking appeals as needed Collaborate with providers, scheduling teams, and billing staff to support efficient, compliant revenue cycle workflows Maintain awareness of payer guidelines, policy changes, and authorization requirements

What We're Looking For:

Required:

2+ years of recent experience in insurance verification, authorizations, and billing in a physician practice (cardiology or specialty preferred) Strong working knowledge of Medicare, Medicaid, PPO, HMO , and commercial insurance plans Experience with insurance portals, EMR/EHR systems , and claim submission software Skilled at obtaining authorizations for both office visits and cardiology diagnostics/procedures preferred Excellent communication and organizational skills with attention to detail Ability to work independently and follow through on pending verifications or appeals Preferred but

Not Required:

Experience working in a cardiology or other high-volume specialty practice preferred Familiarity EMR; EPIC preferred Biller certification or training is a plus, but not required for this role